2011 Health Equity Summit

The Affordable Care Act and Beyond: Achieving Health Equity

September 17, 2011 8:30 – 4:30pm.

Oakland Asian Cultural Center

389 9th Street #290, Oakland, CA 94607

The Health Equity Summit examines strategies and policies aimed at giving everyone the best opportunity to reach the highest level of health. Achieving health equity requires valuing everyone equally with a focused effort of addressing avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.

Racial and ethnic minorities still lag behind whites in many health outcome measures. Our communities are less likely to get the preventive care we need to stay healthy, more likely to suffer from serious illnesses, such as diabetes or heart disease, and when we do get sick, are less likely to have access to quality health care.

Social and economic policies have a direct impact on the health and well-being of everyone who lives, works, learns, and plays under those policies. Achieving health equity will require addressing impacts of our policy decisions – from housing and employment to education and transportation – on the health of our communities.

The push to provide affordable quality care came from the ground up and all across the health care system. Doctors, nurses, patients, businesses, hospitals, health care providers, community groups and policymakers at the national, state and local levels came together to modernize our system.

This effort continues as the Administration, policymakers and community health leaders work together to advance a health equity agenda.  With health care reform, millions of uninsured and underinsured Americans will receive health coverage, building the foundation for our continued efforts to eliminate racial and ethnic health and health care disparities. Our communities are working to ensure that implementation at the state level addresses health disparities and closes the gap on coverage.

These efforts go hand in hand with the U.S. Department of Health and Human Services’ (HHS) establishment of the National Partnership for Action to End Health Disparities and the National Stakeholder Strategy of Achieving Health Equity, two strategic plans that represent the country’s first coordinated roadmap to combating health disparities and to move the nation toward achieving health equity.

In addition, The Congressional Tri-Caucus – comprised by the Congressional Asian Pacific American Caucus, Congressional Black Caucus and Congressional Hispanic Caucus – is joining with communities across the nation to build on the gains provided by health care reform to address disparities in a more comprehensive and integrated way.  The Health Equity and Accountability Act of 2011 can provide the tools necessary to address these health inequities and ensure that health and health care disparities elimination are prioritized.

Together, our communities and our elected leaders will work to increase awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic, and underserved populations; strengthen and broaden leadership for addressing health disparities at all levels; and ultimately improve health and health care outcomes for racial, ethnic, and underserved populations.

U.S., Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, Office of Minority Health, Call for Comments on existing National Standards for the Culturally and Linguistically Appropriate Services in Health Care. The public comment period begins September 20, 2010 and concludes December 31, 2010. During this time three regional meetings will be held throughout the country.

• Baltimore, MD,           Oct. 22, 2010
• San Francisco, CA,       Nov 4 2010
• Chicago, Illinois,          Nov 15, 2010

Registration is requested for each meeting. See link to register and more details on location and times.

For additional details on providing comments, please  go to https://clasenhancements.thinkculturalhealth.org/

Opening Date August 29, 2010.

For more info, go here: http://grants.nih.gov/grants/guide/rfa-files/RFA-MD-11-001.html

Part I <http://www.healthlaw.org/images/stories/PPACA_Part_I.pdf>  includes an analysis of the private insurance reforms and state-based exchanges;

Part II <http://www.healthlaw.org/images/stories/PPACA_Part_II.pdf>  includes an analysis of changes to the Medicaid program; and

Part III <http://www.healthlaw.org/images/stories/PPACA_Part_III.pdf>  analyzes selected provisions from other titles of the PPACA and Reconciliation law.

Dear Advocate,

Asian Americans and Pacific Islander Americans account for 50% of people with chronic hepatitis B in the US but only 45% – less than half know they are infected. It is time to raise awareness within our communities AND among our legislators about this epidemic. These resolutions are important elements of our campaign to eliminate hepatitis B transmission in the U.S. Please call your Representative & Senators today and ask them to sign on! All the info you need is below/attached.  WE NEED YOUR VOICE TO ELIMINATE HEPATITIS B TRANSMISSION!

ACTION ALERT

Call your Representative and Senators to Cosponsor Congressional Resolution on World Hepatitis Day and National Hepatitis Awareness

Dear Colleagues-

Call your Representative AND Senators to ask that they become cosponsors of the House and Senate resolutions designating May 19th as World Hepatitis Day and the month of May as National Hepatitis Awareness Month.

This Resolution supports the goals and ideals of World Hepatitis Day, May 19 and the month of May as National Hepatitis Awareness Month. The goals of World Hepatitis Day and National Hepatitis Awareness Month are to highlight the global chronic viral hepatitis epidemics, to recognize the need for a comprehensive public education and awareness campaign designed to help infected patients and their physicians identify and manage the disease, and to help increase the length and quality of life for those diagnosed with chronic hepatitis B and C infections.

Background
House of Representatives
Representatives Joseph “Ahn” Cao (R-LA), Mike Honda (D-CA), Hank Johnson (D-GA), Charlie Dent (R-PA), and Bill Cassidy (R-LA) recently introduced a National Hepatitis Awareness Month and World Hepatitis Day resolution (H.RES.1302). The more Members of the House that cosponsor H.RES.1302 in advance of World Hepatitis Day on May 19, the better the chance of passage. A copy of the Dear Colleague letter is attached and below. The following is a list of current cosponsors:

Rep Cao, Joseph [LA-2]
Rep Baldwin, Tammy [WI-2]
Rep Bordallo, Madeleine Z. [GU]
Rep Boustany, Charles W., Jr. [LA-7]
Rep Cassidy, Bill [LA-6]
Rep Christensen, Donna M. [VI]
Rep Chu, Judy [CA-32]
Rep Davis, Danny K. [IL-7]
Rep Dent, Charles W. [PA-15]
Rep Grijalva, Raul M. [AZ-7]
Rep Hinojosa, Ruben [TX-15]
Rep Honda, Michael M. [CA-15]
Rep Johnson, Henry C. “Hank,” Jr. [GA-4]
Rep Kennedy, Patrick J. [RI-1]
Rep Lee, Barbara [CA-9]
Rep Melancon, Charlie [LA-3]
Rep Norton, Eleanor Holmes [DC]
Rep Richardson, Laura [CA-37]
Rep Sutton, Betty [OH-13]
Rep Wu, David [OR-1]
Rep Young, Don [AK]

Senate
Senator Diane Feinstein (D-CA) will be introducing the Senate resolution on or near May 19. Please note that there is no bill number as the Senate resolution has not been introduced yet. Her office is recruiting original cosponsors to list when the resolution is introduced. A copy of the Dear Colleague letter is attached and below.

Action
Ask Members of Congress to become cosponsors of the House and Senate resolutions designating May 19th as World Hepatitis Day and the month of May as National Hepatitis Awareness Month.

It is urgent that your calls and/or e-mails be made immediately. Please call your Representative’s and Senators’ Washington, DC office. Ask to speak to the staff person who handles health issues. You can call the Capitol switchboard at 202.225.3121. Ask to be connected to your Representative’s or Senator’s office. If you do not know who your Representative and Senators are, you can go online to www.house.gov and www.senate.gov.

You may also send the staff person an e-mail. Please ask for the person on the phone to spell the person’s name for you as they often will not give out e-mail addresses. Typically in the House, e-mail addresses are firstname.lastname@mail.house.gov as in corinna.dan@mail.house.gov and in the Senate it is firstname_lastname@senatorlastname.senate.gov as in corinna_dan@mikulski.senate.gov. Note the period and underscore between the names when e-mailing the House and Senate respectively.

Whether you speak to this person directly, leave a message or e-mail, tell them:

“My name is ____________________ and I’m a constituent of Representative/Senator____________________. I am calling to urge my Member of Congress to cosponsor a Congressional Resolution designating May 19th as World Hepatitis Day and the month of May as National Hepatitis Awareness Month.

[If you are calling a Representative] H.RES.1302 was introduced with bipartisan support from Representatives Joseph “Ahn” Cao (LA), Mike Honda (CA), Hank Johnson (GA), Charlie Dent (PA), and Bill Cassidy (LA). [If you are calling a Senator] The Senate Resolution is going to be introduced by Senator Diane Feinstein (CA) and we need you as an original co-sponsor.

Hepatitis B and C affect over 5 million Americans and is the leading cause of liver cancer, one of the most deadly, expensive, and fastest growing killers of Americans every year, and the leading cause of liver transplants each year. This Resolution is an important, cost-neutral and non-controversial step to increase the much-needed awareness of hepatitis among the American public and our health providers. This is important to me personally because________.”

If you have any questions, please contact Corinna Dan (cdan@aapcho.org) or Colin Schwartz (cschwartz@NASTAD.org). Thanks for taking the time to contact your Members of Congress!

See below for the final amended resolution.

Note: There is a file embedded within this post, please visit this post to download the file.

Who owns health inequalities?

Constance A Nathanson, Mailman School of Public Health, Columbia University, New York
The Lancet, Volume 375, Issue 9711,  23 January 2010
Website: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60119-5/fulltext

“…..Are health “inequalities” a problem of the poor (and thus soluble by changing poor people’s circumstances or behaviour) or are they an effect of rigid patterns of social stratification (requiring that resources be redistributed)? Are they “voluntary”—the result of bad choices (“booze and fags”)—or “involuntary”—the consequence of oppressive social structures? Should inequalities be framed as “disparities”—mere differences that may or may not be the result of human action—or as unacceptable “inequities”?

And finally, who “owns” health inequalities? Are they—as in the 19th century—a public health problem or are they a medical care problem? Are they a private problem or a public problem? These are not logical or empirical questions. They are political questions. How they are answered will depend on the policy preferences of those in power, or who aspire to power. I illustrate these points with the examples of the UK and the USA, countries at the extremes of public policy in this domain…..”

Diversity in the Health Professions- A New Report

Sullivan and Mittman, “The State of Diversity in the Health Professions a Century after Flexner,” Academic Medicine, Volume 85 issue, 246-253,   February 2010
Website: http://journals.lww.com/academicmedicine/Abstract/2010/02000/The_State_of_Diversity_in_the_Health_Professions_a.21.aspx

The paper is a review article about diversity in the health professions since the Flexner report of 1910, which while revolutionizing medical education, led to the closure of five out of the only seven medical schools that trained African Americans.  It is among 27 articles published in a special Flexner Centenary issue, focusing on the 19th century educator Abraham Flexner, his legacy and his impact on medical education.  The paper draws attention to the limited gains in diversity in the health professions despite decades of interventions and calls for better integration and coordination of efforts among schools and funders to increase diversity.

One of the key statements of the authors is that arguments for diversity in the health professions tend to emphasize benefits to minority populations only, rather than benefits to all, inadvertently leading to the pigeonholing of minority health professionals while “absolving” other providers from the need to pursue public service.  The paper also stipulates that diversity interventions do not stop at medical school graduation but rather must afford equity in further opportunities to excel and lead. The authors call for statewide collaborations to recruit, support and nurture the growth of minorities in the health professions.

Modest and Uneven: Physician Efforts to Reduce Racial and Ethnic Disparities

Issue Brief No. 130, February 2010
Authors: James D. Reschovsky, Ellyn Boukus
Website: http://www.hschange.org/CONTENT/1113/

While many U. S. physicians identify language or cultural barriers as obstacles to providing high-quality patient care, physicians’ efforts to overcome communication barriers are modest and uneven, according to a new national study released today by the Center for Studying Health System Change (HSC).

Racial discrimination and health: A systematic review of scales with a focus on their psychometric properties

Joao Luiz Bastosa, Roger Keller Celesteb, Eduardo Faersteinb and Aluisio J.D. Barrosa
a Post-graduate Program in Epidemiology, Federal University of Pelotas, Department of Social MedicinePelotas, Rio Grande do Sul, Brazil
b Post-graduate Program in Public Health, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Social Science & Medicine – Available online 1 February 2010.
Website: http://bit.ly/cW430p

‘……The literature addressing the use of the race variable to study causes of racial inequities in health is characterized by a dense discussion on the pitfalls in interpreting statistical associations as causal relationships.

In contrast, fewer studies have addressed the use of racial discrimination scales to estimate discrimination effects on health, and none of them provided a thorough assessment of the scales’ psychometric properties. Our aim was to systematically review self-reported racial discrimination scales to describe their development processes and to provide a synthesis of their psychometric properties.

Please read individual chapters and take some time to add your voice to the thousands of concerned voices from around the United States. The link is http://www.minorityhealth.hhs.gov/npa/templates/browse.aspx?lvl=1&lvlID=31

If you have any questions, please contact Ms. Rochelle Rollins, PhD, Director, Division of Policy and Data, Office of Minority Health, at Rochelle.Rollins@hhs.gov or call 240-453-8222.

OMO has signed onto a letter in support of increased payment rates for Medicaid. Medicaid payment rates are currently much lower than Medicare payment rates, and the gap continues to widen. As a result, more and more health care providers are declining participation in Medicaid. The House health reform bill contains a provision (s.1721) that would “increase the payment rate for primary care service codes over three years so that they equal the Medicare payment rates for those services.”

However, the Senate version does not have this provision, and the White House did not budget for it. Unless we speak up immediately and contact our legislators, it is likely that this provision will not make it into final health reform bill.  Please make your voices heard by contacting your Senators and Representatives and by signing onto letters like the one below.

From the HIV Medical Association…

Dear Majority Leader Reid, Speaker Pelosi and Chairmen Rangel, Waxman, Miller, Baucus, Dodd and Harkin:

As you craft the final health care reform bill, the undersigned organizations urge you to ensure meaningful access to care under the proposed Medicaid expansion by adopting the House provision to bring Medicaid reimbursement rates for primary care in line with comparable Medicare rates within four years.

While we strongly support expanding Medicaid to extend health coverage to low income individuals, we are very concerned that failure to address reimbursement disparities will weaken an already fragile network of Medicaid providers at a time when the demand for their services will be growing.

Medicaid rates average just 66% of Medicare rates for primary care services and are woefully inadequate to cover the cost of providing care.  According to the Congressional Budget Office, the planned expansion will increase enrollment in Medicaid and the Children’s Health Insurance Program by as many as 15 million beneficiaries.  Those who rely on Medicaid to meet their health care needs include millions of low-income women, children, minorities and individuals with disabilities.   The inadequacy of Medicaid reimbursement levels must be addressed in conjunction with the Medicaid expansion or we risk leaving our poorest and most medically-vulnerable residents behind despite the remarkable promise offered by health reform.

Please give high priority to ensuring access to care for Medicaid beneficiaries by adopting the House provision to adjust Medicaid payments for primary care to at least 100 percent of Medicare rates.

Thank you for your consideration.

Sincerely,

American Academy of Family Physicians
American College of Physicians
Doctors for America
HIV Medicine Association
The National Association of Public Hospitals and Health Systems
Out of Many, One

To sign onto this letter, please click here: http://www.surveymonkey.com/s/MedicaidHCR . Please sign on by Tuesday (1/12) Noon ET.

Thanks to the National Health Law Program (www.healthlaw.org) for alerting us.

The conference will be held October 18-21, 2010 in Baltimore, MD. The theme for the conference is “Improving health care for culturally diverse populations: A new place on the national health agenda.” They are currently requesting presentation proposals for this nationally acclaimed conference, which attracts over 600 participants every two years.

Health care professionals, community representatives, advocates, policymakers, researchers and others from the U.S. and around the world can submit brief proposals on good practices and innovative approaches related to the following thematic categories: language access, culturally competent care/disparity reduction, cultural competence/disparity reduction education and training, organizational cultural competence, policy, and research.

Proposals are due February 1, 2010. Full details on the Call for Proposals is available at www.diversityrxconference.org/proposals.